Active NPI
Murray Brian Rudenberg, PH.D.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1336368331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 12844
- Practice address
- 2423 Camino del Rio S Ste 106
San Diego, CA 92108-3734 - Phone
- (858) 729-0692
- Fax
- (858) 638-1576
- NPI assigned
- Apr 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 12844 | CA | Primary |
Addresses
Primary practice location
2423 Camino del Rio S Ste 106
San Diego, CA 92108-3734
Mailing address
2423 Camino del Rio S Ste 106
San Diego, CA 92108-3734
Phone (858) 509-7575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8775 Aero Dr
Suite 238
San Diego, CA 92123-1756
Phone (619) 930-9524
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12844 | CA | MD | Professional Counselor |
| PSY 12844 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Psychology Centers, Apc | Current | Accepting new patients | |
| Mihir Parikh, M.D. Inc | Current | Accepting new patients | |
| Eye Institute of California Medical Group Inc | Past | Accepting new patients | |
| Robert Zalewski-Zaragoza, MD, Inc | Past | Accepting new patients |
Locations
8775 Aero Dr
San Diego, CA 92123
Phone (858) 565-4148
8775 Aero Dr
Ste 238
San Diego, CA 92123
Phone (619) 930-9524
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1336368331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2423 CAMINO DEL RIO S STE 106",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083734",
"telephone_number": "858-509-7575",
"fax_number": "858-794-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2423 CAMINO DEL RIO S STE 106",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083734",
"telephone_number": "858-729-0692",
"fax_number": "858-638-1576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDENBERG",
"first_name": "MURRAY",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 12844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.